| NPI | 1902267040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.19123-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH F0216576) |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2016-05-16 |